高血压脑出血患者β淀粉样蛋白的表达及其与血肿周围组织细胞凋亡的关系  

The expression of amyloid β in patients with hypertensive intracerebral hemorrhage and itsrelationship with apoptosis of perihematomal tissue

作　　者：李达[1] 余阶洋[1] 林雄[2] 周柳芳 黎辉[1] 

机构地区：[1]百色市人民医院重症医学科,广西百色533000 [2]百色市人民医院神经外科,广西百色533000 [3]百色市人民医院心血管内科,广西百色533000

出　　处：《中国急救医学》2017年第12期1148-1151,I0010,共5页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨高血压脑出血（hypertensiveintracerebralhemorrhage，HICH）患者8淀粉样蛋白（amyloidp，A13）表达及其与血肿周围组织细胞凋亡的关系。方法收集2014—06～2017-02我院收治的42例拟行颅脑血肿清除术的HICH患者。根据发病到接受手术时间，将42例患者分为A组（〈6h，20例）、B组（6～12h，9例）、C组（12～24h，6例）、D组（24～48h．4例）和E组（〉48h，3例）。以血肿周围组织为研究标本，以远离血肿脑组织为对照标本。分别予以HE染色，原位末端标记法（TUNEL）检测各组血肿周围组织凋亡细胞。ELISA法和免疫组化法检测各组血清和血肿周围组织A13的表达。结果与对照标本比较，A、B、c、D、E组血肿周围组织凋亡细胞个数均增多（P〈0．05）；与A组比较，B、c、D、E组血肿周围组织凋亡细胞个数均增多（P〈0．05），且随着HICH发病时间到接受手术时间的延长，血肿周围组织凋亡细胞个数呈先增多后减少，以24～48h血肿周围组织凋亡细胞个数最多；与A组比较，B、C、D、E组血清AB表达均升高（P〈0．05），血肿周围组织A13阳性细胞个数均增多（P〈0．05），且随着HICH发病时间到接受手术时间的延长，血清和血肿周围组织AB的表达呈先升高后下降，以12—24h血清和血肿周围组织A13的表达最高；与对照标本比较，A、B、c、D、E组血肿周围组织A13阳性细胞个数均增多（P〈0．05）；Pearson相关分析，血清Aβ含量和血肿周围组织凋亡细胞个数之间呈正相关（r=0．482，P：0．001），血肿周围组织Aβ阳性细胞个数和血肿周围组织凋亡细胞个数之间呈正相关（r=0．940，P〈0．001）。结论HICH患者血肿周围组织中存在着大量凋亡细胞。HICH血清和血肿周围组织存在Aβ高表达。Aβ可能参与HICH血肿周围组织细胞凋亡。Objective To explore the expression of amyloid β （Aβ） in patients with hypertensive intracerebral hemorrhage （HICH） and its relationship with apoptosis of perihematomal tissue. Methods 42 HICH patients who underwent brain hematoma removal in our hospital were enrolled from June 2014 to February 2017. According to the time of onset to surgery, 42 HICH patients were divided into A group （ 〈 6 h, 20）, B group （6 -12 h, 9）, C group （12 -24 h, 6） , D group （24 - 48 h, 4） and E group （ 〉 48 h, 3）. The perihematomal tissue was taken as the research sample and the brain tissue away from the perihematomal as the control sample. Morphology changes were dected by HE staining. The apoptosis of perihematomal tissue was detected by TUNEL. The expression of serum A~ and perihematomal tissue AI5 were detected by ELISA and immunohistochemistry respectively.Results The number of apoptosis of perihematomal tissue of the A, B, C, D, E groups were all increased compared with the control sample （ P 〈 0.05 ） ; The number of apoptosis of perihematomal tissue of the B, C, D, E groups were all increased compared with the A group （P 〈 0.05 ）, which increased first and then decreased with the time of HICH onset to surgery, the highest were at 24 ~ 48 h ; Compared with the A group, the expression of serum A[3 of the B, C, D, E groups were all increased （P 〈 0.05 ）, and the number of A{3 positive cells in perihematomal tissue were all increased （ P 〈 0.05）. which first increased and then decreased with the time of HICH onset to surgery, the highest were at 12 ~ 24 h; Compared with the control sample, the number of AI3 positive cells in perihematomal tissue of the A, B, C, D, E groups were all increased （P 〈 0.05 ） ; Pearson correlation, the level of serum A~ were positively correlated with the number of apoptosis of perihematomal tissue （ r = 0.482, P = 0. 001 ）, the number of AI3 positive＇cells in perihematomal tissue were positively correlated with the number of apoptosis

关 键 词：高血压脑出血(HICH) β淀粉样蛋白(Aβ) 血肿周围组织 细胞凋亡 

分 类 号：R493[医药卫生—康复医学]